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Commentary: 5 Ways to Overcome Trouble Sleeping

03/08/22 Richard J. Schwab, MD, University of Pennsylvania, Division of Sleep Medicine|Penn Sleep Center;

We’ve all been there —lying in bed, knowing we should be sleeping in order to feel rested and ready for the next day. Yet for one of countless reasons, we can’t fall asleep. We’re distracted by our phones, or we just can’t seem to shut off our brains, or we’re still feeling the effects of that afternoon cup of coffee. There’s nothing more frustrating than trying (and failing) to fall asleep.

We spend a third of our lives asleep, yet we still don’t fully understand the role shuteye plays when it comes to our brains and our bodies. Fortunately, we know lot about the different stages of sleep and how they impact restfulness. We know that we typically cycle through four stages of sleep several times each night. The first three stages are nonrapid eye movement sleep (NREM), and the fourth is rapid eye movement (REM) sleep. The third stage of NREM, known as “deep sleep,” is perceived as high-quality sleep, and more time is spent in REM sleep as the night progresses.

Generally, the key to a good night’s sleep means maximizing the time spent in deep sleep and REM sleep. Here are five ways to do that and get a better night’s sleep.

1. Know how much sleep you need

How much sleep do adults need? The answer varies, but most people need between 6 and 10 hours. We all know people who seems to function just fine on less sleep and others who seem to need more. The reality is, it’s hard to pinpoint how much sleep you need. Lots of people are sleep deprived throughout the day, relying on coffee and other external factors to help get through the day.

Here’s a good rule of thumb: If you’re consistently using an alarm to wake up, you’re probably not getting enough sleep.

2. Know when to see a doctor

There are several conditions that can impact the quality of sleep. The most common is sleep apnea. People with sleep apnea often are sleepy during the day, snore loudly, and have episodes of gasping or choking, pauses in breathing, and sudden awakenings with a snort. People experiencing these symptoms should see a doctor. Fortunately, sleep apnea can be treated, which can lead to significant improvements in wakefulness throughout the day as well as improved overall health.

Several other conditions can impact a person’s ability to fall asleep and the quality of their sleep. Insomnia and excessive daytime sleepiness are common sleep-related problems with a wide range of causes, including sleep apnea, narcolepsy, and restless leg syndrome. A doctor can help manage these conditions and help eliminate causes to improve sleep and restfulness. 

3. Stick to a good bedtime routine

Changing your approach to sleep—also known as sleep hygiene—can be a tremendous benefit. There are several things you can do (or avoid) to best set yourself up for success at bedtime.

  • Go to bed and wake up around the same time each day – including weekends.
  • Read or take a bath before bed to help wind down and relax.
  • Only drink coffee and other caffeinated beverages in the morning.
  • Get some exercise throughout the day, but avoid it in the two hours before bedtime.
  • Avoid blue lights in the bedroom (cell phones, tablets, TVs, etc.).

In cases when improved sleep hygiene isn’t enough, individuals can see a trained sleep therapist to develop strategies and skills to help sleep.

4. Avoid alcohol (and understand the impact of marijuana)

Alcohol is one of the biggest obstacles to good sleep. Although it may help you fall asleep more quickly, it actually disrupts sleep cycles. It can also make sleep apnea and snoring worse. As marijuana and edibles become more popular, patients should know that they may experience insomnia if they stop after a period of chronic use.

5. Don’t rely on wearables too much

Smart watches and other devices often claim to monitor and provide feedback on sleep cycles and quality of sleep. These devices are getting better all the time, and they can offer a good baseline or serve as a jumping off point for a conversation with a doctor. The data they provide should be taken with a grain of salt.

For more about sleep, visit the Manuals page. 

Test your knowledge
Dacryocystitis is infection of the tear sac usually due to a blockage in the tear duct of the eye. Dacryocystitis causes the tear sac to bulge and may occur suddenly (acute) or be longstanding (chronic). Which of the following symptoms is similar in both the acute and chronic forms of this condition?